医院在医疗赔偿中的责任分析

发布时间：2019-06-29 07:23

【摘要】：多年来因医疗损害赔偿纠纷引发的医患关系紧张的现象，束缚了医务人员的工作主动性和积极性，甚至对医务人员的人身安全造成影响。随之出现的过度医疗、防御性医疗等现象，不仅严重制约了我国医疗卫生事业的发展，最终将侵犯的是全民的共同利益。本文通过例举医疗纠纷赔偿案例，以我国医疗纠纷处理原则为依据，从以信赖为前提的委托合同和侵权法角度，分析医院在医疗赔偿中可能承担的责任；并横向分析英美及日本法中对医疗纠纷中医生责任的认定，得出结论：1.无论是依据契约合同还是侵权责任来解读本案例，向患者或其近亲家属的说明义务或患者或其近亲家属的知情同意权均是医院方面最需要重视的部分，，是本案例中医方承担的医疗赔偿责任主要原因；2.本案例中尽管医院应承担赔偿责任，医方的治疗方式选择未超出治疗规范，同时患者出现肠粘连、不完全性肠梗阻未目前医学技术难以完全避免，因此定性为医疗事故欠妥。侵犯患者知情同意权不应等同于医疗事故；3.医疗行为存在其特殊性，尽管医方在诊疗过程中为优势方，但诊疗过程存在“结果不保证”的特点，因此“避免后见之明”规则可以借鉴。4.行业协会与保险公司的联合，使第三方参与承担责任，可以更为公正妥当的评判医疗责任的有无及赔偿金额多少。可作为缓解医患双方的直接对立关系方法之一。文章旨在通过例举医疗纠纷赔偿案例，分析医院在医疗赔偿中可能承担的责任，为维护医务人员的正常工作秩序和切身利益提供参考
[Abstract]:Over the years, the tense relationship between doctors and patients caused by disputes over medical damage compensation has restricted the initiative and enthusiasm of medical staff, and even has an impact on the personal safety of medical staff. The phenomena of excessive medical treatment and defensive medical treatment not only seriously restrict the development of medical and health care in our country, but also infringe on the common interests of the whole people. Based on the principle of medical dispute settlement in our country, this paper analyzes the possible responsibilities of hospitals in medical compensation from the point of view of trust-based entrustment contract and tort law, and horizontally analyzes the cognizance of doctors' liability in medical disputes in Anglo-American and Japanese laws, and draws a conclusion. Whether on the basis of contractual contract or tort liability to interpret this case, the obligation to explain to patients or their close relatives' families or the right of informed consent of patients or their close relatives is the most important part of the hospital, which is the main reason for the medical liability of traditional Chinese medicine in this case; 2. In this case, although the hospital should bear the liability for compensation, the choice of treatment method does not exceed the treatment standard, at the same time, the patient appears intestinal adhesion, incomplete intestinal obstruction is not completely avoided by the current medical technology, so it is characterized as improper medical accident. Infringing the right of informed consent of patients should not be equated with medical malpractice; 3. Medical behavior has its particularity, although the medical prescription is the dominant side in the process of diagnosis and treatment, but the diagnosis and treatment process has the characteristics of "result is not guaranteed", so the rule of "avoiding hindsight" can be used for reference. 4. The combination of industry associations and insurance companies, so that third parties participate in the responsibility, can be more fair and appropriate to judge the availability of medical liability and the amount of compensation. It can be used as one of the methods to alleviate the direct antagonism between doctors and patients. The purpose of this paper is to analyze the possible responsibilities of hospitals in medical compensation by giving examples of cases of compensation for medical disputes, and to provide reference for maintaining the normal working order and vital interests of medical staff.
【学位授予单位】：上海交通大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：D923;D922.16

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